Doctor wants to raise awareness during Crohn’s and Colitis Month

Dr. Bookman

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Dr. Ian Bookman, a gastroenterologist at St. Joseph's Health Centre, speaks about the myths, misconceptions and treatment options for those suffering from Crohn's Disease and Ulcerative Colitis, in recognition of Crohn's and Colitis Awaress Month, this month.

The average length of time between the onset of symptoms and diagnosis of inflammatory bowel diseases, such as Crohn’s Disease or Ulcerative Colitis, is two years, according to Dr. Ian Bookman, a gastroenterologist at St. Joseph’s Health Centre.

In recognition of Crohn’s and Colitis Awareness Month this month, Bookman set out to debunk some of the myths and misconceptions of Inflammatory Bowel Disease (IBD), a group of disorders that cause sections of the gastrointestinal tract to become severely inflamed and ulcerated. An abnormal response of the body’s immune system plays a role in each of the two main forms of IBD – namely Crohn’s disease (CD) and ulcerative colitis (UC).

“People think a diagnosis of Crohn’s Disease or Ulcerative Colitis means an automatic shortened life expectancy; they need surgery or they’ll spend most of their life in hospital when for the majority of people, this is not true,” said the physician.

CD and UC cause an inflammation of the digestive track, which absorbs nutrients from food while getting rid of waste. UC affects the large bowel and symptoms include, blood in the stool, cramping and diarrhea; CD has similar symptoms, but includes abdominal pain, a decrease in appetite, fever and difficulty gaining weight, said Bookman.

The two conditions were lumped together historically before it was recognized they are two distinct processes, he said.

“They both affect the colon, also known as the large intestine, but scientists are not entirely certain why certain people get these diseases nor what triggers the onset of symptoms,” he said. “They tend to have a peak incidence of early 20s and second incidence in the 70s. The symptoms are still similar, but the onset of the disease in the elderly tends not to be as severe.”

However, according to medical literature, IBD can affect people ages 15 to 40 with a second peak of 50 to 80, added Bookman.

Nowadays, medications have expanded. The majority of patients are able to control their disease with medication alone, said Bookman. Medication can be administered in pill form, as suppositories, an enema, by injection in the skin or intravenously.

“Sometimes, when it’s most appropriate, the treatment option is removing part of the bowel. Removing the colon equals a cure for Ulcerative Colitis. There is no cure for Crohn’s disease,” said Bookman.

Treatment also includes surgery called a colostomy in which the large intestine is brought up to a bag or pouch. This procedure is still occasionally needed temporarily or permanently, said Bookman.

“We are developing new surgical techniques that allow us to reconnect the bowel,” he said.

These diseases cause the immune system to turn on the bowel and start attacking it. The latest class of medication is treating the molecules involved in the immune system. Some are on the market and others are about to be released.

One in 150 Canadians are affected by IBD, according to the Crohn’s and Colitis Foundation of Canada (CCFC). Our country has one of the highest prevalences of IBD in the world. More than 10,200 new cases are diagnosed every year – 5,700 with CD and 4,500 with UC, says the CCFC.

There is no specific diet that ensures a healthy bowel, however, doctors recommend Canada’s Food Guide as a tool for eating a well-balanced, healthy diet.

“We hope to, in the future, be able to predict who will be prone to (these diseases) and know what to do to prevent it,” said Bookman.